Chest Abdomen Spine Pelvis

State the boundaries of the thoracic cavity

Anteriorly: Sternum and Costal Cartilages of the ribs

Posteriorly: Thoracic vertebrae

Superiorly: Root of the neck

Inferiorly: Diaphragm

Laterally: 12 pairs of ribs and intercostal muscles

What consists of the bony thorax?

Sternum, ribs, coastal cartilage, thoracic vertebrae

What are the functions of the bony thorax?

Protection: important organs such as the lung and heart and also the liver and stomach from any shock or trauma

Movement: moves from the articulation of the ribs to allow lung expansion during inspiration and anchorage to muscles provide structural support

Support: Upper limb as it articulates with manubrium and clavicle and support the lungs so that it does not get deflated or constricted

The shoulder girdle is made up of…

2 sets of clavicles and scapula

What does pectoralis MINOR attaches to?

scapula and the ribs

What does pectoralis MAJOR attaches to?

humerus to the sternum

Where are the diaphragm peripherally attached to?

Anteriorly: xiphoid process of the sternum and costal margin of the thoracic cavity

Laterally: Tip of the 11th and 12th ribs

Posteriorly: Lumbar vertebrae

State the ‘pleura’ layers

Visceral pluera are visceral layers of serous membrane that lines the surface the lungs

Parietal pleura are outer layers of serous membrane that lines the interior walls of thoracic cavity

What is the pleural cavity?

The space between the parietal and visceral pleuras that have serous fluid within, secreted by serous membranes - which lubricates the movement of the lungs during inspiration as it can cause friction.

Identify the pathology and symtpoms patient may present

There is opacity in the left lower lung field with meniscus line at the left costophrenic angle. This appearance is consistent with pleural effusion. The most common symptom is shortness of breath

Identify this pathology and state the symptoms

There is increased translucency and absence of peripheral lung markings in the left lung field. Increased opacity is noted medially towards the mediatstinum, and the mediastinum is shifted towards the right side, crossing the midline, indicating a left lung collapse. Appearance consistent with pnuemothorax

Symptoms patient might have

1. sharp stabbing pain

2. dyspnoea and cyanosis

Identify this pathology and patient’s symptoms

Opacification of the left lower lung field which appears consistent with consolidation and disrupts the silhouette of the left hemidiaphragm indicating abnormality of the left lower lobe. Appearance consistent with bacterial pneumonia.

Symptoms patient might have

1. dyspnea

2. Fever

Identify this pathology

Hazy opacification present throughout bilateral lung fields, symmetrically distributed

Appearances consistent with viral pneumonia

Symptoms are dry cough, difficulty breathing, fast heart rate and fever

Label the parts

A: 1st thoracic vertebrae

B: 4th right true rib

C: 8th right false rib

D: 1st left true rib

E: Manubrium of the sternum

F: Body of sternum

G: Xiphoid of sternum

H: 7th left costal hyaline cartilage

Right hypochondriac region

Liver, Gallbladder, Right kidney

Epigastric region

Stomach, Liver, Pancreas and Both kidneys

Left hypochondriac region

Stomach, Spleen, Left kidneys and Tip of Liver

Right Lumbar regions

Ascending colon, small intestines, right kidney and tip of the Liver

Umbilical region

Small intestines, Stomach, Pancreas and transverse colon

Left lumbar region

small intestines, descending colon, left kidney

Right iliac region

Small intestines, appendix, caecum and ascending colon

Hypogastric region

Small intestines, sigmoid colon and bladder

left iliac region

small intestines, descending colon and sigmoid colon

Name the part and state its features

Stomach.

A J-shaped organ that consists of the fundus, body and pylorus

Has cardiac and pyloric sphincter

Has rugae which helps in expansion and absorption as it is able to increase in surface area

Stomach’s function

Store food and digest it by chemically and mechanically breaking it down. It also has defensive mechanism such as mucous lining that protects the gastric cavity, aids in vomiting to remove harmful contents in the stomach and production of gastrin hormone to produce more stomach acid.

A: Central abdomen
B: Peripheral of the abdomen
C: Valvulae conniventes
D: Haustra
E: less than of equal to 3cm. More than 3cm suggest small bowel obstruction
F: less than or equal to 5.5cm. More than 6 cm suggest large bowel dilation

G: Duodenum, Jejunum, Ileum
H: Caecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum

Function of small intestine

Completion of chemical digestion

Absorption of nutrients from vili

Transport antigens and bacteria from Peyer’s patches

What are the curvatures within the colon?

Hepatic flexure from ascending to transverse colon

Splenic flexure from transverse to descending colon

Functions of large intestine

Absorption of remaining water, electrolytes and nutrients

Microbial activity

Peristalsis movement to transport stool through colon

function of liver

synthesis of bile, excretion of bilirubin and detoxification of drugs and hormones

function of gallbladder

store, concentrates and release bile

function of pancreas

aids in digestion by producing pancreatic juice and glucose metabolism by producing insulin

function of spleen

it is part of the lymphatic system which aids in phagocytosis and immune response

function of kidney

form and excrete waste in the form of urine. it also secretes erythropoietin and renin

function of adrenal glands

produce adrenaline

Which vertebrae has costal facets or demifacets?

thoracic vertebrae

What are the abdominal cavity boundaries?

Superior boundary are the diaphragm

Inferior boundary are the pelvic cavity

Anterior boundary are anterior abdominal muscles

Posterior boundary are lumbar vertebrae, psoas muscles and quadratus lumborum muscles

What are the boundaries of the pelvic cavity?

Superior boundary is the abdominal cavity

Inferior boundary is the pelvic floor muscles

Anterior boundary are the pubis symphysis and pubic bone

Posterior boundary are the sacrum and coccyx

RA and symptoms of renal calculus

opacity seen in kidneys, ureters or bladder indicating kidney stones. patient may present with difficulty in passing urine or hematuria

Identify this pathology and state its symptoms

There is abnormal dilation evidenced by loss of haustra markings and dilation of more than 6cm of the colon. Appearance consistent with toxic megacolon.

Patient may present symptoms of abdominal bloatedness accompanied with acute pain and constipation

Identify the radiography appearance and define the pathology. Provide patient’s symptoms.

Occurs when the bowel twist itself and the mesentry that support it

Appearance on X-ray: coffee-bean sign, multiple dilated gas filled loops of bowel and large central loops of distended large bowel arising from pelvis

Symptoms: abdominal distension, pain, vomiting, constipation and bloody stools

Identify the type of bowel obstruction

Distension of colon from gas filled bowels are more peripherally located with slight loss in haustra markings. Collapse of bowel distal to the obstruction is seen. This indicates large bowel obstruction

Identify this pathology and describe the RA and symptoms

It can be seen as free air under the diaphragm in the shape of a crescent also known as pneumoperitoneum which occurs when the bowel perforates and its content leaks into the peritoneal cavity

Symptoms include acute pain, fever, can experience septic shock

What are the natural curvatures of the spine?

Primary curve: thoracic curve and sacral curve (anteriorly concave)

Secondary curve: cervical curve and lumbar curve (anteriorly convex)

Label the parts

A: Lamina
B: Transverse process
C: Superior articular process
D: Superior articular facet

E: Pedicle
F: Vertebral body
G: Vertebral foramen
H: Vertebral arch
I: Spinous process

Label

A: Spinal cord
B: Vertebral foramen
C: Superior articular facet
D: Facet for articulation with head of ribs
E: Spinous process
F: Transverse process
G: Lamina
H: Pedicle
I: Vertebral body

Label

A: Transverse process
B: Intervertebral disc
C: Lamina
D: Pedicle
E: Body

F: Spinal nerve exiting from intervertebral foramen
G: Spinal cord
H: Facet of superior articular process
I: Facet for head of rib
J: Inferior articular process
K: Spinous process

Flat surface of an articular process is called..

Facet

A facet that faces backwards are..

Superior articular facets

A facet that faces forwards are..

Inferior articular facets

How does a facet joint form?

Superior articular facet of one vertebrae articulates with an inferior articular facet of the vertebrae above

What type of joints are facet joints?

Synovial joints

What type of joints are found between adjacent vertebral bodies

Intervertebral cartilaginous joints

What is located between superior and inferior articulation process of each vertebrae?

Pars interarticularis

Where are intervertebral discs found?

C2 - S1

Function of intervertebral discs

Shock absorber and spine flexibility

End of spinal cord

Conus medullaris

Extension of the spinal cord

cauda equina

state what passes through and label

Spinal cord passes through.

A. Inferior intervertebral notch

B. Vertebral body

C. Intervertebral foramen

D: Anulus fibrosis of Intervertebral disc

E: Superior intervertebral notch

Label

1. Anterior tubercle

2. Anterior arch

3. Lateral mass

4. Transverse process

5. Transverse foramen

6. Superior articular facet

7. Posterior arch

8. Posterior tubercle

9. Vertebral foramen

Label

1. Odontoid process

2. Vertebral body

3. Superior articular facet

4. Vertebral foramen

5. Inferior articular process

6. Lamina

7. Bifid spinous process

8. Vertebral arch

9. Transverse process

10. Transverse foramen

Label and state their function

A: Nucleus pulposus, which is the gelatinous core that is responsible for absorbing shock and keeping the vertebrae separate
B: Cartilaginous endplates, which are made up of hyaline cartilage and it is responsible for fusing the vertebral bodies to the intervertebral disc

C: Annulus fibrosus, which is made up of strong ring-shaped cartilage and forms the outer rim of the intervertebral disc. It is responsible for distributing pressure equally

Describe kyphosis, its common location and radiographic appearance

Kyphosis is when the thoracic spine's curvature that is concave anteriorly become more exaggerated. it is seen on the X-ray lateral view of the spine

Describe lordosis, its common location and radiographic appearance

Lordosis is the exaggerated anterior convex of the lumbar or cervical spine and it can be seen on a lateral view of the spine on x-ray

Describe scoliosis, its common location and radiographic appearance

Scoliosis is when there is lateral curvature that affects the whole spine which can be seen on AP standing X-ray examination

Define the pathology, describe radiographic appearance and symptoms

There is an appearance of intervertebral disc narrowing and osteophyte formation. Appearance is consistent with spondylosis of the cervical spine. Patient may present with stiffness, neck pain and neurological symptoms such as numbing or tingling of the arms

Define this pathology and its radiographic appearance and symptoms that patients may present

There is a crack or fracture at the pars interarticularis at the 4th lumbar vertebrae, and it is seen as a scotty dog sign.

Appearance is consistent with spondylolysis, which occurs when there is trauma or a developmental defect. Patient may experience lower back pain during extension or rotation of the spine

Define the pathology by describing its radiographic appearance and state its symptoms

There is the slipping of the vertebrae of 4th lumbar to 5th lumbar vertebrae as evidenced by disruption of the alignment of vertebral bodies seen. This aligns to spondylolisthesis. Symptoms patient may present includes pain that worsens while doing activity or flexion and extension of the spine

Common symptoms or clinical indication of spinal injury

Pain, stiffness, numbness or tingling

Osteoporosis

Osteoporosis is when the bone loses its density and strength as it loses bone mass faster than it can be rebuild, making it weak and prone to fracture.

Define the pathology and describe its radiographic appearance and symptoms

There are segments of the spine that appear fused and are bamboo-like, align with ankylosing spondylitis which is a chronic inflammatory rheumatic disease. Symptoms include stiffness, loss of flexibity and pain

Prolapsed intervertebral disc

Occurs when there is herniation of the intervertebral disc caused by spine degeneration, poor posture, repetitive strain

Label

A: Iliac crest
B: Anterior Superior Iliac Spine
C: Greater trochanter
D: Pubis symphysis
E: Pubic inferior ramus

What consists of hemipelvis?

Ilium, ischium and pubis

Function of the pelvis

The pelvis connects the trunk to the lower limbs, supports lower abdominopelvic organs and provides stability for the trunk

Label

A: Sacral promontory

B: Body of 1st sacral segment (S1)

C: Transverse ridges

D: Sacral foramina

E: Coccyx

What bone type are the pelvic bones? And what is its significance?

Flat bones and it is significant as they are more prone to forming metastatic tumours

What type of joints are SIJ?

Synovial plane joint that allow slight rotation when trunk is flexed or extended

What type of joints are symphysis pubis?

Cartilaginous joints that allow minimal movement between the vertebrae of the backbone

What does the hip difffer in from the ball and socket joint?

It has a central ligament that attaches to the fovea capitis of the head of femur whereas the shoulder does not have.

What bones are involved in the hip joint?

Head of femur and the acetabulum consisting of the pubic bone and ischium

Label the lines

A: Illioschial line (P)

B: Iliopectineal line (A)

C: Dome (roof of acetabulum)

D: Anterior wall of the acetabulum

E: Teardrop
F: Posterior wall of acetabulum

G: Shenton’s line

A fracture that occurs on the side opposite of direct trauma

Contrecoup fracture

Mechanism of injury: Lateral compression

Sacral crush fracture and oblique fractures through the pubic rami

Mechanism of injury: Anteroposterior compression

open book fractures

in x-ray it appears as diastasis of the symphysis pubis, sacroiliac joint widening

Mechanism of injury: Vertical shearing

Vertical displacement of major components and are very unstable fractures

Describe (in xray images and patient’s symptoms) osteoarthritis of pelvis

In x-ray images, it is seen as joint space narrowing, subchondral sclerosis, osteophytes formation and subchondral cysts. Characterized by joint pain, stiffness, reduced range of motion, swelling and crepitus

Identify the pathology

It is affecteded unilaterally, as seen by increased in sclerosis or density at the right side of the pelvis. It appears deformed and has thickened cortex. Trabculae patterns appear coarse and there is cotton wool appearance at the right hemipelvis. Appearance consistent with paget’s disease

Define this pathology and describe the RA and symptoms

Developmental Dysplasia of the Hip is a congenital disease.

In X-ray, it appears as a shallow left acetabulum, an underdeveloped left femoral head and dissociation of the left hip joint

Patient may experience localised pain and limited range of movement of the hip joints

Define, RA and symptoms

Chronic obstructive pulmonary disease is a progressive lung disease that causes breathing difficulties.

in x-ray images it appears as hyperinflated lung fields with increased distance between ribs, flattened diaphragm and narrow mediastinum

Peritoneum

Double wall membrane that lines the visceral layer that lines the abdominal organs and the parietal layer that lines the abdominal wall of the peritoneal cavity.

What are the facet that articulates with the head of rib?

Costal facet or demifacet

What are the facet that joins with the tubercle of rib?

transverse costal facet